Buerger's disease and anticardiolipin antibodies.

Thromboangiitis obliterans or Buerger's disease is an occlusive, inflammatory, nonatherosclerotic vascular disease of unknown etiology, which affects mainly the small and medium arteries, veins and nerves. Anticardiolipin antibodies are associated with arterial and venous thrombosis, repetitive miscarriages and thrombocytopenia. The aim of this study is to bring to attention the diagnosis of Buerger's disease when found in conjunction with anticardiolipin antibodies. Three clinical cases that satisfy Shionoya's criteria for Buerger's disease (except the lack of smoking in one of the cases) are documented in this work. The following examinations were performed: hemogram, creatinine, glycemia, cholesterol, anticardiolipin antibodies, echocardiogram and angiogram. Shionoya's criteria for Buerger's disease were compatible with the two diseases: anticardiolipin antibody syndrome and Buerger's disease, both of which can occur in isolation or associated, thereby complicating the diagnosis. It is concluded that anticardiolipin can be associated with Buerger's disease and may worsen the thrombotic event of the disease but the two entities are separate. The diagnosis is not complicated.

[Intestinal effects of Buerger's disease (thromboangiitis obliterans) case report]. / Compromiso intestinal en la enfermedad de Buerger (tromboangeitis obliterante): reporte de un caso.

A case of an adult patient with intra-abdominal mass syndrome and acute surgical abdomen due to chronic intestinal ischemia with localized perforation and ileal necrosis associated to hepatic granulomatosis and mesenteric adenitis produced by Buerger's disease (thromboangiitis obliterans) is presented herein. The clinical presentation, diagnosis, handling and prognosis of this rare entity were examined.

Buerger's disease and anticardiolipin antibodies: a worse prognosis?

The case of a 26-year-old male chronic smoker is reported, who had thrombotic incidences on three occasions in both upper and lower limbs over a 10-month period. Laboratory examinations, including hematologic studies and creatinine, cholesterol, and glucose levels, were normal. However, IgG and IgM anticardiolipin antibodies were detected. Duplex ultrasonography confirmed deep venous thrombosis in both lower limbs (two occurrences) and computer tomography depicted an inferior cava vein thrombosis. The patient fulfilled all of Shionoya's criteria for Buerger's disease, thus suggesting an association between anticardiolipin antibodies and this disease.

Buerger's disease at the 'San Juan De Dios' Hospital, Santa Fe De Bogota, Colombia.

OBJECTIVES: To know the clinical characteristics in the presentation of Buerger's disease in San Juan de Dios Hospital, Bogota, Colombia, between 1986 and 1996, and compare them with a previous series from the same Hospital and another reported in international literature; To determine the changes in the form of appearance of the disease. METHODS: We reviewed the clinical information of 22 patients with diagnosis of Buerger's disease, observed between 1986 and 1993, and we added the information of the clinical histories of eight other patients with equal diagnosis, observed between 1994 and 1996 in our Unit. RESULTS: We observed 30 patients: 28 men (93%) and two women (7%), with a ratio M:F of 14:1, with an average age of 39+10 years (range from 18 to 52 years). Sixty percent were younger than 40 years and only the 10% were older than 50 years. The most frequent reasons for consultation were: pain in rest in the affected extremity, gangrene and ulceration in more than 50%. Raynaud's phenomenon in 30%, and the related surgical history in 40%. The pedal pulse was the most compromised followed by popliteal, poster or tibial and femoral. We did not observe the presence of thrombophlebitis. Eighty percent showed compromise of more than one extremity. All of them were active smokers. Three patients showed IgG anticardiolipine antibodies at high level. CONCLUSIONS: The clinical characteristics are similar to those reported, we find also a reduction of the disease diagnosis. It calls to our attention that no thrombophlebitis was found in the present series and the less compromise of the upper extremities with a frequent femoral compromise. All this points toward a change in the natural history of the disease.

Alteraciones de la ultraestructura del músculo esquelético en la enfermedad de Buerger: reporte de un caso / Ultrastructure alterations of skeletal muscle in Buerger's disease

La tromboangeitis obliterante (TAO) o enfermedad de Buerger ha sido considerada una forma de vasculitis relacionada etiológicamente con el hábito tabáquico. De acuerdo a la revisión de la literatura, no existen estudios previos acerca del compromiso muscular en esta enfermedad, esto nos estimuló a reportar el caso de un paciente afectado de la mencionada patología y con signos clínicos evidentes de alteración muscular. Por ese motivo, se realizó biopsia muscular por punción percutánea, con aguja tipo Bergstrom, del músculo cuadriceps femoris. Se procesaron las muestras por métodos convencionales para microscopía electrónica de transmisión. De acuerdo a los resultados ultraestructurales, las alteraciones que se producen en los capilares intramusculares son de tipo isquémico. Igualmente, la presencia de atrofia nos señala un posible daño neural en esta enfermedad. Algunas de las alteraciones observadas en los capilares y en relación con el infiltrado presente podrían sugerir un componente autoinmune en la etiología de la enfermedad

Enfermedad de Buerger en el Hospital San Juan de Dios de Santa Fe de Bogotá

Objetivos. Conocer las características clínicas de la presentación de la enfermedad de Buerger en el Hospital San Juan de Dios de Santa Fe de Bogotá

Comprometimento intestinal pela tromboangiite obliterante: apresentaçäo de um caso / Intestinal compromising by thromboangiitis obliterans: report of one case

Os autores apresentam um caso de isquemia mesentérica aguda em paciente portador de tromboangiitr obliterante. Discutem a raridade do comprometimento intestinal na doença em questäo, assim como as formas de diagnosticá-la

El diagnóstico precoz de la tromboangeítis obliterante / Early diagnosis of thromboangiitis obliterans

Se realiza un trabajo en el que se sugiere la búsqueda sistemática de fleboesclerosis de las regiones anteromaleolares internas en todo paciente con manifestaciones circulatorias de sus extremidades, ya que pudiera tratarse de casos precoces de T.A.O. (etapa inicial); también resulta especialmente útil para la prevención de lesiones vasculares más extensas, en las que la proscripción del tabaco debe aportar los mayores beneficios (AU)